Clinical and Bacteriological Aspects of Impetigo Contagiosa

Abstract

Summary1. The results of an investigation into the clinical, epidemiological and bacteriological features of impetigo contagiosa, with special reference to the type identification of staphylococci and streptococci, are reported and discussed.2. Of 106 impetigo cases studied, Staphylococcus aureus was isolated alone from 86 lesions (81 %), Streptococcus pyogenes alone from 6 (5·6 %), and a mixed growth of Staph. aureus and haemolytic streptococci in 14 instances (13·2 %).3. Of the 100 strains of Staph. aureus isolated from impetigo lesions, 63 were identical in phage type (‘type 71’), and a further 17 were closely related (‘weak 71’).4. Only one representative of ‘type 71’, and 9 of ‘weak 71’, were obtained from 164 strains of Staph. aureus from 200 persons in three control groups.5. Of 90 strains of Staph. aureus from impetigo lesions, 64 (71 %) were resistant to penicillin. Of these penicillin-resistant strains, 54 (84 %) were of ‘type 71’, or close variants.6. Strep, pyogenes was probably causative in at least 6 of the 18 patients yielding this organism from lesions; it was presumed to be a secondary invader in the remainder.7. It is doubtful if nasal carriage is of importance in the epidemiology of impetigo.8. It is concluded that there is a specific ‘type’ of staphylococcus associated with this form of impetigo.

Acute glomerulonephritis in Trinidad: serological typing of group A streptococci

“…For some time it has been recognized that group A streptococci from skin lesions seldom have M-antigens that are detectable with the antisera used in routine typing (Parker et al 1955;Barrow, 1955;Dillon et al 1967). Top et al (1967) have shown that this is not because 'skin' streptococci lack M-antigens, but because they belong to previously unrecognized or supposedly rare M-types.…”

Epidemiology and Treatment of Chronic Staphylococcal Infections in the Household

“…However, even this small difference noted between the two groups (7.4 per cent) was found to be statistically significant at the 1 per cent probability level. Other reports of low association are those of Barrow (1955) that there were individuals who were perineal carriers but not nasal carriers, and that the staphylococci were not in the perineum as contaminants from the neighboring anal orifice, but actually were capable of multiplying in that site. In addition, they found that strains from individuals who were both nasal and perineal carriers were identical.…”

Incidence and recurrence of boils and abscesses within the first year: a cohort study in UK primary care

“…2 The epidemiology of boils and abscesses in primary care is poorly understood. Suppurative skin infections such as sycosis barbae, 3 impetigo, 4 and furunculosis 5 are more common in patients who are colonised with Staphylococcus aureus and there is evidence that boils and abscesses are associated with social deprivation, overcrowding, the use of communal facilities, obesity, diabetes, and impaired immunity. [6][7][8][9] Patients consulting primary care with a boil or abscess will be treated either with antibiotics or with surgical incision and drainage, 10 but treatment options for those with recurrent boils is limited beyond addressing any underlying immune disorders and screening for diabetes.…”